Week 8 - Frostbite

Question 1

what is frostbite

Answer 1

• described as deep tissue freezing

Question 2

briefly describe the patho of frostbite

Answer 2

• results in formation of ice crystals in tissues & cells

Question 3

what is the initial response to cold stress & frost bite

Answer 3

• vasoconstriction

= decreased blood flow & vascular stasis

Question 4

as cellular temp decreases & ice crystals form in the intracellular spaces, what impact does this have ? (4)

Answer 4

• increased intracellular Na and Cl
• cellular membrane destroyed
• organelles damages
  = edema

Question 5

the depth of frostbite depends on? (9)

Answer 5

• ambient temp
• length of exposure
• type & condition of clothing (wet or dry)
• contact w metal surafces
• skin color (dark skinned people more prone)
• lack of caclimatization
• previous episodes
• exhaustion
• poor peripheral vascular status

Question 6

what is a superficial frostbite

Answer 6

• involves the skin & subcut tissue

Question 7

what body parts are usually effected by superficial frostbite (4)

Answer 7

• ears
• nose
• fingers
• toes

Question 8

describe the characteristics of a superficial frostbite (3)

Answer 8

• ranges from pale to blue to mottled
• skin feels crunchy and frozen
• pt may complain of tinging, numbness, burning sensation

Question 9

what is a deep frostbite

Answer 9

• involves muscle, bone, and tendone

Question 10

describe the skin appearance of a deep frostbite (6)

Answer 10

• white
• hard
• insensitive to touch
• involves complete tissue necrosis
• appearance of deep thermal injury
• mottling gradually progressing to gangrene

Question 11

describe the onset of edema and blistering w frostbite

Answer 11

• edema within 3 hrs

- blistering within few hours

Question 12

what is always required w a severe frostbite & why?

Answer 12

• IV analgesia d/t pain associated w tissue thawing

Question 13

what are imp nursing considerations and pt education r/t frostbite (4)

Answer 13

• skin v fragile = area should be handled carefully & never squeezed, rubbed, massaged, scrubbed
• clothing & jewerlly should be removed bc may constrict the extremity, decrease circulation, and in anticipation of edema
• heavy blankets and clothing should be avoided (d/t friction & weight = sloughing of damaged tissue)
• no compression or heating pads

Question 14

what is included in nursing care for frostbites (9)

Answer 14

• analgesics v imp
• affected area should be immersed in lukewarm water bath of 37-30*celsius
• tetanus prophylaxis if approp.
• evaluate for systemic hypothermia
• bed rest
• elevate injured part
• prophylactic antibiotics
• emotional support
• careful & gentle care

Question 15

why are anagesics imp for someone w frostbite

Answer 15

• rewarming is v painful –> often experiences a warm, stinging sensation

Question 16

how long may residual pain from frostbite last

Answer 16

• weeks to years

Question 17

describe treatment for a nonhemorrhagic blisters d/t frostbite

Answer 17

• should be drained, debrided, and covered w sterile dressing

Question 18

what is demarcation

Answer 18

• A zone of inflammatory reaction separating a gangrenous area from healthy tissue

Question 19

deep tissue frostbite requires? how long can this take?

Answer 19

• time to full develop/demarcate

- can take 2 weeks to 5 months

Question 20

when might amputation be required for frostbite (3)

Answer 20

• if area is left untreated
• if treatment unsuccessful
• depends how deep the tissue is necrotic

Question 21

what has been shown to reduce the need for amputation when used in the first 24 hrs of injury

Answer 21

• thrombolytic agents

Question 22

___ is present within the early stages of deep tissue frostbite. ____ in the later stage

Answer 22

• edema = early stage

- demarcation, formation of necrotic tissue = later stages